Richard J MacIsaac
Type 2 diabetes is characterised by insulin resistance, a progressive decline in beta-cell function, and worsening hyperglycaemia. HbA1c levels of <7.0% remain the target for good glucose control but individualisation of glycaemic targets has been advocated by the Australian Diabetes Society (Table 1).1
Many patients with type 2 diabetes need to progress to insulin use when oral glucose
lowering therapies fail to maintain adequate glycaemic control.
To suggest when and how to initiate insulin therapy for patients with type 2 diabetes in
the primary care setting.
In general, initiation of insulin should be considered in individuals on maximal tolerated
doses of metformin and sulfonylureas with HbA1c levels >7.0% over a 3–6 month period.
Current Australian guidelines recommend initiating insulin therapy as once daily basal
therapy or as premixed insulins.
Download the PDF for the full article.